Acute complications in patients with surgical treatment of lumbar herniated disc

The complications of surgical treatment for lumbar disc herniation (LDH) are important to know, but hard to measure because of their low incidence and varied pattern. Using data from the National Hospital Discharge Survey, which codes discharges and procedures according to the ICD-9-CM, we assessed acute complication rates for 3,289 surgically treated LDH patients and 4,025 nonoperative LDH patients, identifying complications from codiagnoses. The complication rates were significantly correlated with the postoperative length of stay and with the risk factors of obesity, hypertension, and diabetes. We found fewer instances of thrombophlebitis (0.3/1,000) and slightly lower mortality (0.9/1,000) than previously reported. Although the frequency of the cauda equina syndrome in the literature approximates our findings of 5/1,000, our data did not allow correction for the fraction of preexistent cauda equina syndromes. Our any-complication-rate is 3.7%. Even though LDH surgery is relatively safe, its complications should not be overlooked.